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Individual

JACOB L ROGERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
224 SHORTER AVE NW, ROME, GA 30165-4288
(706) 235-2727
(706) 235-2726
Mailing address
224 SHORTER AVE NW, ROME, GA 30165-4288
(706) 235-2727
(706) 235-2726

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT012980
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PTO12980
PT LICENSE
GA
Enumeration date
08/17/2017
Last updated
07/21/2022
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